Managing equine asthma: Owner adherence, practical constraints and environmental protocol evaluation

BACKGROUND: Adherence to recommendations for environmental management is central to equine asthma (EA) treatment. Reasons for non-adherence warrant further investigation. OBJECTIVES: To: (1) evaluate adherence to recommendations for environmental changes, identify reasons for incomplete implementation, assess changes in clinical signs and medication use; (2) evaluate owner acceptability, practicality and perceived usefulness of a structured stable-side protocol. STUDY DESIGN: (1) Retrospective online survey and (2) prospective onsite testing with owners of EA-affected horses. METHODS: (1) Online survey on implementation of standardised recommendations, clinical progression and medication use; and (2) environmental protocol evaluation during stable visits. RESULTS: Seventeen of 40 horses still received dry hay and 13/40 were bedded on straw. Reasons for non-implementation included time, financial and infrastructural constraints, boarding stable restrictions, group housing, weather dependence, use of self-produced roughage, perceived ineffectiveness and individual horse preferences. Owners reported that overall clinical impression had improved and the proportion of coughing horses decreased from 88% to 55% (p < 0.001, OR = 0.07, 95% CI 0.002-0.47, n = 40). The other clinical outcomes did not reach the Bonferroni-adjusted significance threshold. Twenty-two horses were still coughing, and 7/40 had received medication within the previous 3 months. All interviewed owners found the environmental protocol helpful, 11 reviewed it again and 5 used it for discussion with others. MAIN LIMITATIONS: Use of small convenience samples, lack of a control group and potential selection and recall bias. CONCLUSION: Owner non-adherence arose from diverse and often structural constraints. The environmental protocol was well accepted by owners and helped to structure discussions on risk factors.